Carolina Breast Cancer Study

卡罗莱纳乳腺癌研究（CBCS）III期是一项成功的SPORE支持的 一项基于人群的研究，检查乳腺癌的遗传和流行病学风险因素及特征 癌症，重点是非洲裔美国人（AA）和绝经前乳腺癌。研究报告 大约2000名参与CBCS I期和II期的乳腺癌患者证明， AA种族和年轻的基底细胞样乳腺癌预后差的患病率高， 相反，预后良好的Luminal A亚型的患病率较低。此外，重新评价 传统的危险因素表明亚型的影响具有相当大的异质性;独特的遗传和 生活方式因素与基底细胞样乳腺癌的关系已经被观察到， 相反的方向，根据与整体乳腺癌风险的关联预期。基于这些结果， 我们假设，年轻的非洲裔美国人乳腺癌的发病率和死亡率较高， 女性与白色女性相比的差异是由于多种因素的组合，包括肿瘤生物学的差异， 获得护理的机会和接受的治疗类型。此外，我们还假设， 对这些因素的调查将确定具体的临床和公共卫生干预措施，以降低乳房 癌症死亡率 为了确定与每种乳腺癌亚型相关的因素，CBCS III期于2009年启动。 2008年，将第一阶段至第二阶段的24个县的集水区扩大到北卡罗来纳州的44个县， 到2014年，将增加1500名AA妇女和1500名非AA妇女。CBCS III的目标是 确定乳腺癌临床结果差异的决定因素，包括生物学，种族， 社会经济，行为因素，并确定临床护理（交付和访问）中的可修改因素 解决不平等的原因。CBCS第三阶段超出了单一资金来源的范围， 得到了大学和其他机制的广泛支持，但是， 这个项目的影响。具体来说，SPORE资助肿瘤基因表达谱（Aim 1）， 这将能够评估不同亚型的风险因素分布差异（目标2），并将用于 收集治疗和结局数据，以评估生存结局（目标3）。这项研究将提供一个 乳腺癌的生物学和流行病学以及乳腺癌的差异的全面图片， 生存的风险。

The Carolina Breast Cancer Study (CBCS) Phase III is a continuation of a successful SPORE-supported population-based study examining genetic and epidemiologic risk factors and characteristics of breast cancer with a focus on African-American (AA) and premenopausal breast cancer. Studies from the approximately 2000 breast cancer patients participating in CBCS Phases I and II demonstrated that patients with AA race and young age had a high prevalence ofthe poor prognosis Basal-like breast cancer, and conversely a low prevalence ofthe good prognosis Luminal A subtype. Additionally, reevaluafion of traditional risk factors suggested considerable heterogeneity in effects by subtype; unique genetic and lifestyle factor associations have been observed for basal-like breast cancer, sometimes with effects in the opposite direction as expected based on associations with overall breast cancer risk. Based on these results, we hypothesize that the higher incidence and mortality from breast cancer in younger African American women compared to white women is due to a combination of factors, including differences in tumor biology, access to care, and type of treatment received. Furthermore, we hypothesize that continued comprehensive investigation of these factors will identify specific clinical and public health interventions to lower breast cancer mortality. To identify the factors that are associated with each breast cancer subtype, CBCS Phase III was opened in 2008, expanding the previous 24-county catchment area of Phases l-ll to 44 counties across North Carolina, and will accrue an additional 1500 AA women and 1500 non-AA women by 2014. The goal of CBCS III is to identify determinants of disparities in breast cancer clinical outcomes, including biologic, racial, socioeconomic, behavioral factors, and to identify modifiable factors in clinical care (delivery and access) that address the causes of disparities. CBCS Phase III is beyond the scope of a single funding source and is broadly supported by the University and other mechanisms, however there are crucial translational implications of this project. Specifically, SPORE funding for gene expression profiling on the tumors (Aim 1), which will enable evaluation of differences in risk factors distribution by subtype (Aim 2), and will be used for collection of treatment and outcome data to assess survival outcomes (Aim 3). This study will provide a comprehensive picture ofthe biology and epidemiology of breast cancer and breast cancer disparities, from risk to survival.